A single-center retrospective analysis of liver transplantation on 255 patients with hepatocellular carcinoma

• Published in: Clinical transplantation 2010-11, Vol.24 (6), p.752-757
• Main Authors: Wang, Zheng-Xin, Song, Shao-Hua, Teng, Fei, Wang, Gui-Hua, Guo, Wen-Yuan, Shi, Xiao-Min, Ma, Jun, Wu, You-Min, Ding, Guo-Shan, Fu, Zhi-Ren
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; alpha-fetoprotein; Biological and medical sciences; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - surgery; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Gastroenterology. Liver. Pancreas. Abdomen; Graft Survival; hepatocellular carcinoma; Humans; Liver Neoplasms - pathology; Liver Neoplasms - surgery; Liver Transplantation; Liver, biliary tract, pancreas, portal circulation, spleen; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; Milan criteria; Retrospective Studies; Risk Factors; Salvage Therapy; San Francisco criteria; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Survival Rate; Tissue, organ and graft immunology; Tumors; University of California; University of California, San Francisco criteria; Young Adult
• ISSN: 0902-0063; 1399-0012
• DOI: 10.1111/j.1399-0012.2009.01172.x

Wang Z‐X, Song S‐H, Teng F, Wang G‐H, Guo W‐Y, Shi X‐M, Ma J, Wu Y‐M, Ding G‐S, Fu Z‐R. A single‐center retrospective analysis of liver transplantation on 255 patients with hepatocellular carcinoma. 
Clin Transplant 2010: 24: 752–757. © 2009 John Wiley & Sons A/S. :  Background:  Liver transplantation (LT) was advocated as a salvage treatment of choice for patients with unresectable hepatocellular carcinoma (HCC). This study was designed to assess the eligibility of LT criteria for patients with HCC and to analyze the factors influencing the recurrence of HCC following LT, aiming to further improve the efficacy of LT for patients with HCC. Methods:  Clinical data of 255 patients with HCC who underwent LT between December 2001 and December 2007 at Shanghai Changzheng Hospital, China were retrospectively analyzed. Results:  Among these cases, 75 patients were within the Milan criteria and 180 were beyond it; 110 patients were within the University of California, San Francisco (UCSF) criteria, while 145 were beyond it. The difference in overall survival rates was not only significant between the patients within and beyond the Milan criteria but also between patients within and beyond the UCSF criteria. Tumor‐node‐metastasis (TNM) staging, portal vein tumor thrombus (PVTT), and the pre‐operative alpha‐fetoprotein (AFP) level were independent risk factors affecting the overall survival and post‐operative recurrence‐free survival rates of patients with HCC. Pathological staging and pre‐operative local treatment of HCC had no obvious correlation with the post‐operative recurrence‐free survival rate. Conclusion:  LT is an effective treatment modality for HCC. The UCSF criteria did not show better effectiveness than the Milan criteria. TNM staging, PVTT, and the pre‐operative AFP level are closely related to the recurrence of HCC following LT.